Fibrates

A class of drugs that effectively lowers triglyceride levels and raises levels of “good” high-density lipoprotein (HDL) cholesterol levels. They are not very effective for lowering “bad” low-density lipoprotein (LDL) cholesterol levels. Fibrates (also called fibric acid derivatives) include fenofibrate (brand name TriCor) and gemfibrozil (Lopid).

Type 2 diabetes is associated with a twofold to fourfold excess risk of cardiovascular disease. While total cholesterol and LDL cholesterol levels in people with Type 2 diabetes are similar to or lower than those of people who don’t have diabetes, people with Type 2 diabetes tend to have higher blood triglyceride levels and decreased levels of HDL cholesterol, which could contribute to their high risk of cardiovascular disease.

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According to the American Diabetes Association, the first priority in treating abnormal cholesterol and triglyceride levels in people with Type 2 diabetes should be lowering high LDL cholesterol levels, preferably with a class of lipid-lowering drugs called HMG CoA reductase inhibitors (or “statins”). Fibrates should be used specifically to lower triglyceride levels and raise HDL levels, and they are often used in combination with a statin.

A clinical trial called the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, published in the journal The Lancet in 2005, showed that fenofibrate reduced the risk of cardiovascular events – namely, cardiovascular death, heart attack, stroke, and coronary and carotid artery revascularization procedures – in people with diabetes.